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I request that orders may be passed for restoration of my name in theState Register of '(State). to- I submit three recent passpTt size photographs. I. I submit Nagaland Nursing Coutuil Registrrniofl Ceriiiicate in originaL Declared at. Before............................. Signature ( tor office useonly) Received the above documents in Original. Signature of regiciered Name' Dair *(Enstruc(iofla All fact.,; and the grounds on thieh lite application is made should be dearly and concisely stated. Use separate sheets if netessary. 29, June, 2019 The Nagaland Gazette, Part- V 46 To, FORM-6 Application form for Provisional Registration RecieptNo Dare (For office use) Affix passport sue photograph attested. The Registrar Nagaland Nursing Council Sub: Provisional Registration Sir!Madam, e and other particulars mentioned below may be entered in the State I hereby request that my nam ursing Council as required under section of the Nagaland Nursing Provisional Register of Nagaland N Act 2019, I. Name of the application (block letters)